SAMPLE RE-EVALUATION REQUEST

Date

Child Study Team Case Manager

Child’s School

Address

Dear [ ]:

I am the [parent or guardian] of [child’s name], whose birthday is [ ] and who is a student in the [ ] grade.

Despite receiving services, my child is still experiencing significant difficulties in school Therefore, I am requesting re-evaluations to help determine what changes and or additions to [child’s name]’s program are appropriate.

I understand that a meeting is necessary to determine the nature and scope of the evaluation Please be advised that I am requesting the following assessments be included within the evaluation: [ ]. Furthermore, I understand that the re-evaluation must be conducted upon a parent’s request and the re-evaluation must be complete within sixty days

I look forward to hearing from you regarding the scheduling of the meeting.

Sincerely,